Medical Research Council, Francie van Zyl Drive, Parrow, Cape Town, South Africa.
Bull World Health Organ. 2011 Jan 1;89(1):62-7. doi: 10.2471/BLT.10.079798. Epub 2010 Nov 22.
The World Health Organization released revised principles and recommendations for HIV and infant feeding in November 2009. The recommendations are based on programmatic evidence and research studies that have accumulated over the past few years within African countries. This document urges national or subnational health authorities to decide whether health services should mainly counsel and support HIV-infected mothers to breastfeed and receive antiretroviral interventions, or to avoid all breastfeeding, based on estimations of which strategy is likely to give infants in those communities the greatest chance of HIV-free survival. South Africa has recently revised its clinical guidelines for prevention of mother-to-child HIV transmission, adopting many of the recommendations in the November 2009 World Health Organization's rapid advice on use of antiretroviral drugs for treating pregnant women and preventing HIV infection in infants. However, one aspect of the new South African guidelines gives cause for concern: the continued provision of free formula milk to HIV-infected women through public health facilities. This paper presents the latest evidence regarding mortality and morbidity associated with feeding practices in the context of HIV and suggests a modification of current policy to prioritize child survival for all South African children.
世界卫生组织于 2009 年 11 月发布了修订后的艾滋病病毒和婴幼儿喂养原则和建议。这些建议是基于过去几年在非洲国家积累的项目证据和研究。本文件敦促国家或国家以下卫生当局根据哪种策略可能使这些社区中的婴儿有更大的机会无艾滋病毒存活，来决定卫生服务部门主要应鼓励和支持艾滋病毒感染的母亲进行母乳喂养并接受抗逆转录病毒干预，还是避免所有母乳喂养。南非最近修订了预防母婴传播艾滋病毒的临床指南，采用了 2009 年 11 月世界卫生组织关于使用抗逆转录病毒药物治疗孕妇和预防婴儿感染艾滋病毒的快速建议中的许多建议。然而，南非新指南的一个方面令人担忧：通过公共卫生设施继续向艾滋病毒感染妇女提供免费配方奶粉。本文介绍了与艾滋病毒相关的喂养方式对死亡率和发病率的最新证据，并建议修改现行政策，优先考虑所有南非儿童的生存。
